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Gavin cohen hok vbd presentation
- 1. Getting Hyped about Hyperopic Ortho K Gavin Cohen gavin2020@comcast.net
- 2. When to offer hyperopic ortho K Moderate hyperopic presbyopes ideal Strong motivation, from both the pt. and YOU Aware of expectations – Reduce the dependency… Strong dominant eye Successful previous monovision (LASIK too!)
- 3. When NOT to offer HOK Pts who are hypersensitive to changes in Rx Pts who want perfect vision Pts who’s travel makes it difficult Night patterns that are unusual Any EBMD Early presbyopes with emmetropia
- 4. Caution Not FDA approved Not well published – no significant research vs OK Unknown to most other docs – will get questions Expensive Watch that distance vision Watch that VA fluctuation
- 5. A word about topography Topos from scout are tangential topos, not axial Remember red means steep, not elevation Essentially measuring tearfilm layer Watch the dry eye (consider +1.00 lens) Randy Kojima – “Topographies sometimes lie” Only measures inner 5 mm of K, rest is guesswork All my HOK are large diameter designs so guesswork comes into play
- 6. Video 1
- 7. Video 2
- 9. Probably needs more lift
- 11. Case 1 - SC CEO 55 Male LASIK 15 years previous Excellent results Wearing readers Why is he a good candidate?
- 12. Post Lasik
- 13. Design method
- 15. Post Lasik Topos
- 16. Case 2 - GM 74 year old white female OD : +3.75 20/25 Add : +2.50 OS : +2.25 -0.25 X 180 20/25 Referred by a friend Could not wear lenses during the day. “Sick of glasses” Extremely particular, but motivation high Extensive patient education re expectations
- 17. OD
- 20. OD alteration for better distance VA
- 21. EXCELLENT DISTANCE VISION – Against common design principles probably because large plus required?
- 22. GM - OS
- 24. Case 3 - CH 55 YO Female +1.50 hyperope OU Dry eye, on Restasis Narrow angles sent for PI to friendly MD Glaucoma doc called me, amazed.
- 26. 9 and 3 o’ clock positions of design
- 27. Pre and post topo
- 28. OS dominant topos and design
- 29. Excellent distance vision, reading just OK